MRI多定量序列评估下腰痛与疼痛评分的相关性

目的　分析腰椎磁共振成像（MRI）多定量序列与临床疼痛及功能障碍量表评分之间的相关性。方法　随机选取2018年4月至2019年10月在湖北省第三人民医院行腰椎MRI的腰痛患者120例，其中男性54例，女性66例，年龄18～42（32.18±3.24）岁。根据疼痛时长分为急性下腰痛组45例（疼痛时长≤12周）和慢性下腰痛组75例（疼痛时长>12周）。获取L1/2～L5/S1范围内椎间盘前纤维环、后纤维环、髓核及椎旁肌肉的T1、T2及PD定量值。分别采用视觉模拟量表（Visual Analogue Scale，VAS）及Oswestry功能障碍指数量表（Oswestry Disability Index，ODI）评估患者的疼痛程度及功能障碍程度。采用独立样本t检验分析两组患者一般资料、VAS评分、ODI评分的统计学差异。采用Pearson相关性分析VAS评分、ODI评分与临床资料、前后纤维环、髓核及椎旁肌肉T1、T2及PD定量值的相关性。结果　两组患者性别、年龄等一般资料及Pfirrmann分级差异均无统计学意义（均P>0.05）。两组患者VAS、ODI评分差异均无统计学意义（均P>0.05）。两组患者髓核处T1、T2值，前纤维环T1值及腰大肌处T2值差异均有统计学意义（均P<0.05）。急性下腰痛组VAS评分、ODI评分与Pfirrmann分级呈明显正相关，VAS评分与多裂肌处T2值呈正相关，ODI评分与体质量指数、后纤维环的T2值呈明显正相关，与髓核的PD、T2、T1值呈明显负相关（均P<0.05）；慢性下腰痛组中，VAS评分与后纤维环的PD、T1值呈正相关，ODI评分与后纤维环的T2值呈明显正相关（r=0.414、0.219、0.196，均P<0.05）。结论　腰椎间盘及椎旁肌肉的PD、T2、T1值与VAS评分及ODI评分明显相关。PD、T2、T1值对评价腰椎间盘退变具有重要作用。

Correlation between low back pain and pain score evaluated by MRI multi-quantitative sequence

Objective　To analyze the correlation of the multi-quantitative sequence of magnetic resonance imaging (MRI) with low back pain and score of Oswestry Disability Index (ODI). Methods　One hundred and twenty patients with low back pain who underwent lumbar MRI in Hubei No.3 People's Hospital of Jianghan University from April 2018 to October 2019 were randomly selected, including 54 males and 66 females, and they were 18-42 (32.18 ± 3.24) years old. According to the duration of pain, they divided into an acute low back pain group (45 cases; the pain duration ≤ 12 weeks) and a chronic low back pain group (75 cases; the pain > 12 weeks). The quantitative values of T1, T2, and PD of anterior annulus fibrosus, posterior annulus fibrosus, nucleus pulposus, and paravertebral muscles between L1/2 and L5/S1 were obtained. The Visual Analogue Scale (VAS) and ODI were used to evaluate the degree of pain and dysfunction. The statistical differences in the general data, VAS score, and ODI score between the two groups were analyzed by the independent-sample t test. Pearson correlation was used to analyze the correlation of the VAS and ODI scores with the clinical data and the T1, T2 and PD quantitative values of anterior and posterior annulus fibrosus, nucleus pulposus, and paravertebral muscles. Results　There were no statistical differences in the general data, such as gender, age, and Pfirrmann classification, between the two groups (all P>0.05). There were no statistical differences in the scores of VAS and ODI between the two groups (both P>0.05). There were statistical differences in the T1 and T2 values of nucleus pulposus, T1 value of anterior annulus fibrosus, and T2 value of psoas major muscle between the two groups (all P<0.05). Pearson correlation analysis showed that the VAS and ODI scores were positively correlated with Pfirrmann grade, the VAS score was positively correlated with the T2 value of multifidus muscle, the ODI score was positively correlated with the body mass index and T2 value of posterior annulus fibrosus and negatively correlated with the PD, T2, and T1 values of nucleus pulposus in the acute low back pain group (all P<0.05); the VAS score was positively correlated with the PD and T1 values of posterior annulus fibrosus and the ODI score was positively correlated with the T2 value of posterior annulus fibrosus in the chronic low back pain group (r=0.414, 0.219, and 0.196; all P<0.05). Conclusions　The PD, T2, and T1 values of lumbar disc and paraspinal muscles are significantly correlated with VAS and ODI scores. The values of PD, T2, and T1 play an important role in the evaluation of lumbar disc degeneration.